The study aim was to assess the application of atomic force microscopy (AFM) to evaluate erythrocyte morphology in early stages of type 2 diabetes mellitus, and the association with biochemical, anthropometric, diet, and physical activity indicators.

This was a pilot cross-sectional study with four groups: healthy individuals, people with prediabetes (PDG), metabolic syndrome (MSG), and diabetes mellitus group (DMG). Blood samples were obtained to assess the erythrocyte morphology and biochemical parameters. Anthropometrical measurements were taken. Besides, a diet and a physical activity questionnaire were applied.

The evaluation of the erythrocyte morphology through the AFM showed quantitative and qualitative alterations in the cell's form and size. Compared to the healthy group, the PDG had a reduction in height (-0.80 μm, p < 0.05), and an increase in axial ratio (-0.09 μm, p < 0.05); the MSG had lower concave depth (-0.19 μm, p < 0.05); and the DMG had a decreased height (-0.46 μm, p < 0.05) and concave depth (-0.29 μm, p < 0.05), and higher axial ratio (+0.08 μm) and thickness (+0.32 μm, p < 0.05). The PDG vs. DMG had a statistically significant difference in concave depth (+0.23 μm, p < 0.05) and thickness (-0.26 μm, p < 0.05). The MSG was different than the DMG in variables like axial ratio (-0.05 μm) and thickness (-0.25 μm). Besides, higher values of age, HbA1c, triglycerides, body mass index, waist-to-hip ratio, and physical inactivity were associated with altered erythrocyte morphology.

AFM is a promising instrument to assess early but subtle changes in erythrocyte morphology (height, axial ratio, concave depth, thickness) before significant pathological conditions, such as type 2 diabetes mellitus. HbA1c might have a major effect in altered morphology, vs. metabolic parameters like high triglycerides, body mass index, waist, and physical inactivity.

该研究旨在评估原子力显微镜 (AFM) 在评估 2 型糖尿病早期红细胞形态的应用，以及与生化、人体测量学、饮食和身体活动指标的关联。

这是一项包含四组的试点横断面研究：健康个体、糖尿病前期 (PDG)、代谢综合征 (MSG) 和糖尿病组 (DMG)。获得血样以评估红细胞形态和生化参数。进行了人体测量。此外，还应用了饮食和体力活动问卷。

通过 AFM 对红细胞形态的评估显示了细胞形式和大小的数量和质量变化。与健康组相比，PDG的高度降低（-0.80 μm，p < 0.05），轴比增加（-0.09 μm，p < 0.05）；MSG 具有较低的凹入深度（-0.19 μm，p < 0.05）；DMG 具有降低的高度 (-0.46 μm, p < 0.05) 和凹面深度 (-0.29 μm, p < 0.05)，以及更高的轴比 (+0.08 μm) 和厚度 (+0.32 μm, p < 0.05)。PDG 与 DMG 在凹面深度（+0.23 μm，p < 0.05）和厚度（-0.26 μm，p < 0.05）方面具有统计学显着差异。MSG 在轴比 (-0.05 μm) 和厚度 (-0.25 μm) 等变量上与 DMG 不同。此外，较高的年龄、HbA1c、甘油三酯、体重指数、腰臀比、

AFM 是一种很有前途的工具，可用于在重要病理状况（如 2 型糖尿病）之前评估红细胞形态（高度、​​轴比、凹深、厚度）的早期但细微变化。HbA1c 可能对改变的形态产生重大影响，与高甘油三酯、体重指数、腰部和缺乏身体活动等代谢参数相比。